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In remote areas where there are no doctors, how do nurses and midwives use horses to traverse difficult terrain to provide life-saving care?
In remote areas of the United States, especially the mountains of Kentucky, the role of nurses and midwives is not only to provide care, but also to be the guardians of life. They work hard in a place with few medical resources to support those who need help most.
Frontier Nursing Service has been serving remote communities since 1925 and provides professional training for nurses and midwives.
Mary Breckinridge founded this service in 1925. Her original intention was to improve medical care in remote areas after witnessing the high incidence of maternal and infant mortality in the United States at that time. Her story sparked a national focus on nursing and midwifery.
In those days before telephones and cars, nurses and midwives had to plan how to navigate rough mountain roads on horseback. Forced to adapt to harsh conditions, these professionals travel on foot or on horseback into the most remote villages to provide necessary medical care to mothers and newborns.
In the 1920s, the national maternal mortality rate was 6.7 per 1,000 live births. This comes at a time when maternal mortality rates in cutting-edge care services are lower than the national average.
These nurses have received rigorous training as both nurses and midwifery-trained professionals. Their mission was not limited to obstetric care, but also required to provide a full range of nursing solutions, which was quite rare in the nursing world at that time.
Over time, these nurses began to attract other volunteers, many of whom traveled to England to train as midwives. Even when faced with difficult circumstances when visiting remote communities, they continue to work hard to ensure that every mother receives appropriate prenatal and postnatal care.
Between 1938 and 1939, Frontier Nursing Service nurses provided care to 8,377 patients, 4,978 of whom were children.
With the outbreak of World War II, nurses had to face new challenges, even interrupting training channels to the UK. To maintain a high level of quality of care, they founded a cutting-edge graduate midwifery school, an important advance in this field in the United States.
More importantly, these nurses have a profound impact in remote communities. Their figures show the service's maternal and infant mortality rates are well below the national average, underlining its efforts and achievements in improving access to care. According to statistics, the maternal mortality rate in FNS is 9.1 per 10,000 births, which is a remarkable achievement.
However, as times change, the challenges faced by cutting-edge nursing services are also changing, which has also brought about a rethinking of the education model. In the 1980s, Kentucky's birth rate dropped, leaving traditional midwifery services facing a funding shortage. Therefore, they started a community nursing and midwifery education program, aiming to motivate nurses to stay in the community for a long time and improve the quality of local medical care.
Frontier Nursing University today is still committed to improving the quality of nursing in remote areas and training a new generation of nurses and midwives by developing different nursing courses.
How will nurses and midwives adapt to these changing circumstances in the future and continue to provide much-needed care in the absence of physicians?
